[Federal Register Volume 65, Number 50 (Tuesday, March 14, 2000)]
[Notices]
[Page 13724]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-6171]


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DEPARTMENT OF DEFENSE

Office of the Secretary


Proposed Collection; Comment Request

AGENCY: DOD, Office of the Assistant Secretary of Defense for Health 
Affairs/TMA.

ACTION: Notice.

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    In accordance with Section 3506(c)(2)(A) of the Paperwork Reduction 
Act of 1995, the Office of the Assistant Secretary of Defense for 
Health Affairs/TMA announces the revision of a currently approved 
collection and seeks public comment on the provisions thereof. Comments 
are invited on: (a) Whether the proposed extension of collection of 
information is necessary for the proper performance of the functions of 
the agency, including whether the information shall have practical 
utility; (b) the accuracy of the agency's estimate of the burden of the 
information collection; (c) ways to enhance the quality, utility, and 
clarity of the information to be collected; and (d) ways to minimize 
the burden of the information collection on respondents, including 
through the use of automated collection techniques or other forms of 
information technology,

DATES: Consideration will be given to all comments received May 15, 
2000.

ADDRESSES: Written comments and recommendations on the information 
collection should be sent to the Office of the Assistant Secretary of 
Defense (Health Affairs), TRICARE Management Activity, Office of 
Resource Management, Skyline Drive, Suite 810, 5111 Leesburg Pike, 
Falls Church, Virginia 22041-3206. ATTN: Major Rose Layman, (703) 681-
8910.

FOR FURTHER INFORMATION CONTACT: To request more information on this 
proposed information collection, please write to the above address or 
call Major Rose Layman, Office of the Assistant Secretary of Defense 
(Health Affairs), TRICARE Management Activity, (703) 681-8910.
    Title; Associated Form; and OMB Number: Third Party Collection 
Program; DD Form 2569; OMB Control Number 0704-0323.
    Needs and Uses: The information contained in the DD Form 2569 will 
be used to collect reimbursement from private insurers for medical care 
provided to family members of retirees and deceased Service members 
having health insurance. Such monetary benefits accruing to the 
Military Medical Treatment Facility (MTF) will be used to enhance 
healthcare delivery in the MTF. Information will also be used by MTS 
staff and CHAMPUS Fiscal Intermediaries to determine eligibility for 
care, deductibles, and copayments and by Health Affairs for program 
planning and management.
    Affected Public: Family members of retirees and deceased Service 
members having health insurance.
    Annual Burden Hours: 55,221.
    Number of Respondents: 1,262,194.
    Responses Per Respondent: 1.
    Average Burden Per Response: 2.5 minutes.
    Frequency: Yearly or on occasion when insurance information 
changes.

SUPPLEMENTARY INFORMATION:   

Summary of Information Collection

    The DD Form 2569 is used to collect third party insurance 
information from family members of retirees and deceased Service 
members having health insurance. This information is collected either 
during the inpatient stay admission and/or discharge process or during 
the visit when a patient presents for an outpatient procedure.

    Dated: March 8, 2000.
Patricia L. Toppings,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 00-6171 Filed 3-13-00; 8:45 am]
BILLING CODE 5001-10-M